APPLY TO EASTERN GATEWAY COMMUNITY COLLEGE

To submit an application to our school, please complete the following form and select Submit Application.

= Required

DO NOT use this form if you:

* have ever completed a course with Eastern Gateway Community College in the past as a college student
(or with Jefferson County Technical Institute, Jefferson Technical College,
or Jefferson Community College);

* are a current student who wishes to change their major.

If you fit into the above categories, you simply need to submit a change of major form
and update any name/address information with Student Records before you register for courses.

* A valid Social Security Number or Taxpayer Identification Number is
vital information used to comply with federal and state reporting requirements.
Eastern Gateway Community College will not disclose your SSN or TIN without your
consent unless required by law.

Personal Information

When entering information, please:

* Use proper case (ex. John Doe).
* Do not use special characters (ex. Jane Doe-Smith should be Jane DoeSmith; O'Brien should be OBrien).
* Do not use dashes in the Social Security Number Box. ID should be 123123333
* Do not use punctuation in address (ex. St. should be St).

Please use the following guidelines when choosing a Selective Service option:Exempt = Female OR Male over 27 years of age
Male Under 18 = Male less than 18 years of age not registered for selective service
Not Registered = Male less than 28 years of age not registered for selective service, out-of-state fees apply
Registered = Registered for selective service and has number

Selective Service

Ohio Resident?

If less than 12 months, enter the number of months living in Ohio.

Academic Information

If you will still be enrolled as a high school student while attending EGCC, please select "Undergraduate/Non Degree/High School" for Program

Eastern Gateway Community College is committed to providing reasonable accommodations for students with disabilities. Students are responsible for notifying the college regarding
any disabilities for which they may need special services. Please contact Vanessa Birney at 740.266.9771 or vbirney@egcc.edu for assistance.

Degrees

I certify that the information I have provided on this application is complete and accurate to the best of my knowledge. I understand that misrepresentation of
facts on the application may be cause for refusal of admission, cancellation of admission, or dismissal from the college. By submitting and dating this application, I agree
to abide by the policies and regulations of the college as published in the Eastern Gateway catalog, and I authorize Eastern Gateway Community College to release application,
transcript, enrollment, and assessment information to local, state, and federal agencies, including the school district in which I graduated. Your SSN is not used as your
Student ID number. We request your SSN for compliance with federal and state reporting requirements.
The criteria for admission to Eastern Gateway Community College also requires high school transcripts (or GED certification) as well as college transcripts (if applicable).
Students should request that these be sent to the Office of Admission, 4000 Sunset Boulevard, Steubenville, Ohio 43952. Eastern Gateway provides equal opportunities regardless
of race, color, national origin, sex, disability, age, military status, or sexual orientation. Providing your social security number (SSN) is voluntary. Your SSN is not used as
your student ID number. We request your SSN for compliance with federal and state reporting requirements. Supplying a SSN is necessary for students to qualify for educational
tax credits, enables certification of Veterans benefits, and enables the college to provide information to government entities that require SSN, including but not limited to
the federal government for financial aid and Tax Relief Act (1997) reporting, Immigration and Naturalization Service, and Ohio Board of Regents. Eastern Gateway will not disclose
your SSN without your consent for any other purposes except as allowed by law.
Eastern Gateway Community College is committed to providing reasonable accommodations for students with disabilities. Students are responsible for notifying the college regarding
any disabilities for which they may need special services. Please contact Vanessa Birney at 740.266.9771 or vbirney@egcc.edu for assistance.

Select "I accept" to confirm that you have read and fully understand the terms and conditions set forth in ourApplication Policy